The Senate’s healthcare bill will leave 22 million more people uninsured by 2026, the Congressional Budget Office estimated on Monday.

“By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the CBO wrote.

The changes to the insurance landscape in America would be rapid, the agency wrote; 15 million more people would find themselves without insurance by 2018 alone.

The CBO also said that the bill, known as the Better Care Reconciliation Act, will also see $772 billion in cuts to federal spending on Medicaid, which has rapidly become one of the most vital pieces of the American safety net.